Recent population‐based data on nonalcoholic fatty liver disease (NAFLD) epidemiology in general, and incidence in particular, are lacking. We examined trends in NAFLD incidence in a U.S. community and the impact of NAFLD on incident metabolic comorbidities (MCs), cardiovascular (CV) events, and mortality. A community cohort of all adults diagnosed with NAFLD in Olmsted County, Minnesota, between 1997 and 2014 was constructed using the Rochester Epidemiology Project database. The yearly incidence rate were calculated. The impact of NAFLD on incident MCs, CV events, and mortality was studied using a multistate model, with a 4:1 age‐ and sex‐matched general population as a reference. We identified 3,869 NAFLD subjects (median age, 53; 52% women) and 15,209 controls; median follow‐up was 7 (1‐20) years. NAFLD incidence increased 5‐fold, from 62 to 329 in 100,000 person‐years. The increase was highest (7‐fold) in young adults, aged 18‐39 years. The 10‐year mortality was higher in NAFLD subjects (10.2%) than controls (7.6%; P < 0.0001). NAFLD was an independent risk factor for incident MCs and death. Mortality risk decreased as the number of incident MCs increased: relative risk (RR) = 2.16 (95% confidence [CI], 1.41‐3.31), 1.99 (95% CI, 1.48‐2.66), 1.75 (95% CI, 1.42‐2.14), and 1.08 (95% CI, 0.89‐1.30) when 0, 1, 2, or 3 MCs were present, respectively. The NAFLD impact on CV events was significant only in subjects without MCs (RR = 1.96; 95% CI = 1.35‐2.86). NAFLD reduced life expectancy by 4 years, with more time spent in high metabolic burden. Conclusion: Incidence of NAFLD diagnosis in the community has increased 5‐fold, particularly in young adults. NAFLD is a consequence, but also a precursor of MC. Incident MC attenuates the impact of NAFLD on death and annuls its impact on CV disease. (H epatology 2018;67:1726‐1736).
OP04.01: Interobserver variability of sonographic lung size measurement in congenital diaphragmatic hernia (CDH) across the NAFTNet* FETO Consortium
Network-directed cis-mediator analysis of normal prostate tissue expression profiles reveals downstream regulatory associations of prostate cancer susceptibility loci
Abstract Approximately half of older people report sleep disturbances, which are associated with various health conditions, including neurodegenerative disease and dementia. Indeed, 60 to 70% of people with cognitive impairment or dementia have sleep disturbances, which are linked to poorer disease prognosis. Sleep disturbances in people with dementia have long been recognized and studied; however, in the past 10 years, researchers have begun to study disturbed sleep, including sleep fragmentation, abnormal sleep duration, and sleep disorders, as risk factors for dementia. In this review the authors summarize evidence linking sleep disturbance and dementia. They describe how specific aspects of sleep (e.g., quality, duration) and the prevalence of clinical sleep disorders (e.g., sleep-disordered breathing, rapid eye movement sleep behavior disorder) change with age; how sleep parameters and sleep disorders are associated with the risk of dementia; how sleep can be disturbed in dementia; and how disturbed sleep affects dementia prognosis. These findings highlight the potential importance of identifying and treating sleep problems and disorders in middle-aged and older adults as a strategy to prevent cognitive decline and dementia. The authors also review recent evidence linking sleep disturbances to the pathophysiology underlying dementing conditions, and briefly summarize available treatments for sleep disorders in people with dementia.
Abstract 4222: Examining sociodemographic disparities in perceptions of cancer risk from medical imaging radiation
Abstract In the United States, ionizing radiation from medical imaging is estimated to account for nearly half of the total radiation exposure among the general population. While controversial, some estimates suggest thousands of future cancer cases can be attributed to radiation from medical imaging. With the advancement in medical technologies, understanding the health risks of radiation from medical imaging has become increasingly complex for the average cancer patient. This complexity may shape the public’s perceptions of the potential cancer risks of medical imaging tests, including as x-rays, mammography, and radioactive dyes. Due to the enumerable, often misleading, sources of information available to the average consumer regarding the effect of radiation on general health, trends in risk perception need to be assessed. To investigate the association between perceptions of radiation exposure from medical imaging and cancer risk, we analyzed data from the National Cancer Institute's Health Information National Trends Survey (HINTS 4, Cycle 2). HINTS is a probability-based nationally-representative survey which collects data on the American public’s knowledge, perception, and use of cancer- and health-related information since 2003. The data examined in the present study were collected between October 2012 and January 2013; (response rate = 39.97%). Bivariate analyses reveal individuals who perceive medical imaging radiation to be harmful to health are largely female, Hispanic, non-Hispanic Black, or non-Hispanic Asian, with less education and lower incomes. This perception is especially prevalent in individuals who self-report having a poor or fair general health and less confidence in their ability to take care of their own health. After adjusting for sociodemographic and health care factors, a significantly increased odds of believing radiation from medical imaging causes “some” or “a lot” of harm to health was found among those who have had a previous cancer diagnosis compared to those who did not (OR=1.67, 95%CI=1.18-2.35). Individuals who self-reported being Hispanic (OR=2.08, 95%CI=1.29-3.34), non-Hispanic Black (OR=1.54, 95%CI=1.09-2.19), and non-Hispanic Asian (OR=4.66, 95%CI=2.05-10.62) had significantly higher odds of perceiving “some” or ”a lot” of harm to health from medical imaging compared to non-Hispanic white counterparts. Our data reveal existing populations that perceive radiation from medical imaging is harmful to health. These perceptions, particularly among women and minorities, may affect the personal decisions of cancer care from individual patients. Future analyses may be useful to identify whether these perceptions alter health outcomes, especially related to frequency of patients declining cancer radiation therapy. Overall, understanding patient perceptions of radiation exposure and cancer risk may help guide conversation and education for physicians with their patients. Citation Format: Kekoa Taparra, Kay Pepin, Richard Moser, Bradford Hesse, Alexandra Greenberg. Examining sociodemographic disparities in perceptions of cancer risk from medical imaging radiation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4222. doi:10.1158/1538-7445.AM2017-4222
Abstract 1318: A genome-wide association study of Waldenström macroglobulinemia/lymphoplasmacytic lymphoma demonstrates association with chromosome 6
Abstract Waldenström macroglobulinemia (WM) is a unique subset of lymphoplasmacytic lymphoma (LPL) that is defined by the presence of an LPL infiltrate in the bone marrow together with a monoclonal IgM protein in the serum. A somatic activating mutation, MYD88 L265P, occurs in 85+% of WM and in 25%-50% of patients with the precursor condition, IgM monoclonal gammopathy of undetermined significance (MGUS); however, germline MYD88 mutations have not been observed in WM patients, and the genetic basis for WM predisposition remains undefined. To identify novel WM susceptibility loci we conducted a two-stage genome-wide association study (GWAS) in over 450 WM cases and 4300 controls of European ancestry. Discovery (stage 1) included 217 WM cases (40% familial) and 3798 controls genotyped on the Illumina Omni Express or Illumina Omni2.5 platforms following standard quality control procedures. The genotyped data were imputed using the Haplotype Reference Consortium panel as a reference and analyzed using logistic regression. In stage 1, we identified three loci on chromosomes 6, 14 and 3 significantly associated (P<5.0x10-8) with risk of WM. Eleven promising SNPs in these and other suggestive loci (P<5.0x10-7) were selected for replication (stage 2) in 269 WM or LPL cases (4% familial) and 571 controls, and genotyping was conducted using standard methods on Taqman and Sequenom platforms or Sanger sequencing (1 SNP). Preliminary results confirm replication of the chromosome 6 locus. Stratification on familial status will illuminate the contribution of familial disease. These results will provide insight into the underlying genetic basis of WM susceptibility. Citation Format: Mary L. McMaster, Sonja I. Berndt, Shengchao A. Li, Susan Slager, Joseph Vijai, Charles C. Chung, Bin Zhu, Laurie Burdette, Brenda Birmann, Elizabeth E. Brown, James R. Cerhan, Karin Ekstrom-Smedby, Henrik Hjalgrim, Geffen Kleinstern, Brian K. Link, James McKay, Alain Monnereau, Lindsay M. Morton, Alexandra Nieters, Nathaniel Rothman, Christine F. Skibola, Alex Smith, Lauren R. Teras, Claire M. Vajdic, Roel Vermeulen, Belynda Hicks, Lynn R. Goldin, Neil E. Caporaso. A genome-wide association study of Waldenström macroglobulinemia/lymphoplasmacytic lymphoma demonstrates association with chromosome 6 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1318. doi:10.1158/1538-7445.AM2017-1318
Plasma Sphingolipids are Associated With Gait Parameters in the Mayo Clinic Study of Aging